Research News

Children with Type 2 diabetes more likely to have poor oral health, microbiome study finds

By ELLEN GOLDBAUM

“This is the first study to look at the salivary microbiome in pediatric populations.”

Lucy Mastrandrea, associate professor

Department of Pediatrics

The first study of oral health in children with Type 2 diabetes,
including those who are obese, has found that these children tend
to have poorer oral health than children who do not have Type 2
diabetes.

Published earlier this month in PLOS One, the study
of three groups of children – 19 normal weight children, 14
obese children and 16 obese children with Type 2 diabetes –
found that poor oral health is more common in obese children with
type 2 diabetes. The age range for all groups was 10-19.

The research was funded by the Endocrine Fellows Foundation and
by Colgate-Palmolive; neither funder had any role in the design,
data collection, analysis or preparation of the manuscript.

“We found a trend toward more periodontal disease in obese
children with Type 2 diabetes,” said Lucy Mastrandrea, senior
author, associate professor in the Department of Pediatrics in the
Jacobs School of Medicine and Biomedical Sciences at UB and a
pediatric endocrinologist with UBMD Pediatrics. She also is
associate chief of endocrinology at Women & Children’s
Hospital of Buffalo.

The idea for the study was generated by a conversation
Mastrandrea and co-author Waleed F. Janem, formerly a pediatric
endocrinology fellow at UB and Women & Children’s
Hospital of Buffalo, had with Harvey Berman, associate professor in
the UB Department of Pharmacology and Toxicology. Berman was
initially interested in how access to dental health might impact
obese adolescents with Type 2 diabetes.

“It turns out that while obese adolescents with Type 2
diabetes typically do have access to dental health, often through
federally funded insurance, they do not routinely go to the
dentist,” said Mastrandrea.

The connection between poor oral health and adults with diabetes
is well known, she explained. According to the paper, oral
inflammation has been detected not just in adults with diabetes,
but even in adults with prediabetes.

However, to the researchers’ knowledge, there
haven’t been any studies on the oral health of children with
obesity or diabetes or on the pediatric microbiome.

“The most important finding of this research is that, like
adults, children with Type 2 diabetes appear more vulnerable to
periodontal inflammation than normal lean or obese children,”
said co-author Frank A. Scannapieco, chair and professor of the
Department of Oral Biology in the School of Dental Medicine.
“It provides justification for the need for additional
attention to oral hygiene in children with Type 2
diabetes.”

The work also provides an important foundation for further
investigations into the microbiome of children.

“This is the first study to look at the salivary
microbiome in pediatric populations,” Mastrandrea said.
“We know that having inflammation anywhere in your body may
influence your microbiome. At the same time, we know that having
diabetes may influence your microbiome or, alternatively, that
changes in the microbiome may increase your risk for
diabetes.”

Mastrandrea is interested in exploring, in a longitudinal study,
whether better dental care right after diagnosis might help
mitigate the trend toward more periodontal disease in children with
Type 2 diabetes. She’s also interested in whether the same
trends hold true for children with Type 1 diabetes.

The microbiome work was carried out at the UB Center for
Microbiome Research in the New York State Center of Excellence in
Bioinformatics and Life Sciences. The researchers isolated DNA from
the saliva of children and sequenced the bacterial sequences with
assistance from Maria Tsompana, co-author and senior research
scientist in the Department of Epidemiology and Environmental
Health, UB’s School of Public Health and Health
Professions.

Bioinformatics and statistical analyses were provided by
Amarpreet Sabharwal, clinical assistant instructor of periodontics
and endodontics, and by Jeffrey C. Miecznikowski, associate
professor of biostatistics in the School of Public Health and
Health Professions, both of whom are co-authors. Elaine Haase,
research associate professor in the Department of Oral Biology, is
also a co-author.